Endodontic retreatment of a lower canine associated with a periapical lesion: case report of an unusual anatomy

ObjectivesTo describe the endodontic orthograde retreatment of a lower canine with a rare anatomy, affected by a symptomatic periapical lesion.Materials and methodsA 30-year-old Caucasian woman came to our office reporting severe pain and swelling located at the right mandible. A two-roots/two-canals configuration was discovered for the lower canine which sustained the periapical infection; a missed lingual canal was not recognized and treated at the previous primary endodontic therapy.A full pre-operative examination and diagnosis, the application of modern endodontic strategies along with the use of magnification technologies (like the Surgical Operating Microscope - SOM) and proper disinfection protocols were employed for endodontic re-treatment.Result and conclusionsHealing of the periapical infection was clinically and radiographically confirmed at a 9-month follow-up. Endodontists should know the anatomical variations of human teeth and be vigilant about them when approaching treatments. More than a single radiographic projection is recommended in the diagnostic phase.Careful procedures related to instrumentation, cleaning and filling of the entire root canal system enhance the potential for healing of apical lesions